Ji Ran, Wang Wei, Yang Yining, Hu Ming, Mao Xiang, Qi Zhiqiang, Chen Zhihao
Department of Otorhinolaryngology Head and Neck Surgery,Tianjin First Central Hospital,Tianjin,300192,China.
Department of Radiotherapy,Tianjin First Central Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Apr;38(4):310-315. doi: 10.13201/j.issn.2096-7993.2024.04.009.
To explore the clinical efficacy of surgical excision combined with low-energy X-ray irradiation in the treatment of ear keloids. Clinical data of 32 cases of ear keloid lesions that received surgical treatment alone or surgery combined with radiotherapy from March 2019 to November 2022 in the Department of Otorhinolaryngology Head and Neck Surgery of the Tianjin First Central Hospital were retrospectively analyzed. Among them, 10 cases received radiotherapy and 22 cases did not receive radiotherapy. The radiotherapy group received irradiation with a large divided dose of 50 kV low-energy X-rays. The mode of fractionation radiotherapy was as follows: the first was 10 Gy of intraoperative radiation therapy and the second was 8 Gy on the 3rd postoperative day for a total of 18 Gy. The local efficacy and skin radiation reaction were observed at a follow-up of 8-52 months. The median follow-up was 26 months, and as of the date of the last follow-up, 9 cases were cured and 1 case was ineffective in the radiotherapy group, with an effective rate of 90.0%, while 9 cases were cured and 13 cases were ineffective in the no-radiotherapy group, with an effective rate of 40.9%. The recurrence of ear keloids was not related to the side, site, or etiology of the patient's onset(>0.05). Recurrence was related to whether or not the patients received radiotherapy(²=4.885, <0.05), and the recurrence rate in the radiotherapy group(10.0%) was significantly lower than that in the non-radiotherapy group(59.1%). Surgical excision combined with low-energy X-ray irradiation therapy is an effective method of treating keloids in the ear, especially with intraoperative radiation therapy can achieve more satisfactory results.
探讨手术切除联合低能量X线照射治疗耳部瘢痕疙瘩的临床疗效。回顾性分析2019年3月至2022年11月在天津市第一中心医院耳鼻咽喉头颈外科接受单纯手术治疗或手术联合放疗的32例耳部瘢痕疙瘩病变的临床资料。其中,10例接受放疗,22例未接受放疗。放疗组采用大分割剂量50 kV低能量X线照射。分割放疗模式如下:第一次为术中放疗10 Gy,第二次为术后第3天8 Gy,共18 Gy。随访8 - 52个月,观察局部疗效及皮肤放射反应。中位随访时间为26个月,截至末次随访日期,放疗组9例治愈,1例无效,有效率为90.0%,而未放疗组9例治愈,13例无效,有效率为40.9%。耳部瘢痕疙瘩的复发与患者发病的侧别、部位或病因无关(>0.05)。复发与患者是否接受放疗有关(²=4.885,<0.05),放疗组的复发率(10.0%)明显低于未放疗组(59.1%)。手术切除联合低能量X线照射疗法是治疗耳部瘢痕疙瘩的有效方法,尤其是术中放疗可取得更满意的效果。